• Clinical and Experimental Pediatrics
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• v.51 no.9
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• pp.992-997
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• 2008

Purpose : Hypertension (HTN) is no longer an exclusively adult disease; the prevalence of pediatric HTN is increasing. To understand the evaluation and treatment of childhood HTN in Korea, we investigated, via a questionnaire, how hypertensive children are currently assessed and managed by pediatric cardiologists (CA) and nephrologists (NE). Methods : We surveyed 82 pediatric CA and 77 NE, regarding how they manage hypertensive children in Korea. Results : A total 75 replies were received to our questionnaire request (response rate: 47.15%). Routine blood pressure (BP) checks were more frequently performed by NE (CA: 5.7%, NE: 25%, P=0.03), but most respondents (86%) did not check BP routinely. Mercury sphygmomanometers were the most commonly used devices and ambulatory blood pressure monitoring was not frequently used. The goal BP in treated patients was set at the 95th percentile by 61% of respondents. NE used a lower BP goal in hypertensive children with renal disease (CA: 24%, NE: 64%, P=0.004) or DM (CA: 12.5%, NE: 50%, P=0.003). Angiotensin converting enzyme (ACE) inhibitors were the most commonly used agents (mean: 59%); following ACE inhibitors, CA preferred diuretics for hypertensive children with renal disease or cardiovascular disease, and NE preferred calcium channel blockers, regardless of underlying disease. Self-monitoring was the most frequent method for BP monitoring at home. Conclusion : In Korea, BP measurement is not yet a routine examination in treating hypertension. There are some differences in management strategies vis-$\grave{a}$-vis hypertension, between pediatric cardiologists and nephrologists. For the appropriate management and prevention of secondary disease in long-term studies, standard guidelines and education are needed for pediatricians.

• Hwankyungkyoyuk
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• v.7 no.1
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• pp.106-122
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• 1994

The purpose of this study to investigate the awareness of environmental management knowledge and behavior and the effect of independent variables (The environmental management behavior of housewives are composed of five activities-clothing, eating, housing, buying, family management. The independent variables are composed of objective variable and subjective variable). The Research Questions are as follows; 1. Are there significant differences in the housewife's awareness of the environmental management knowledge according to the objective variable and the subjective variable? 2. How much are the effects of related variables on the awareness of environmental management knowledge? 3. Are there significant differences in the housewife's environmental management behavior according to objective variable and subjective variable and awareness of environmental management knowledge? 4. How much are effects of related variables on the housewife's environmental management behavior? For these purpose, a theoretical framework was developed by literature review and applied to empirical test. The data was collected through the questionnaire those respondents were 477 housewives in seoul. It was analyzed by various statistical methods such as Frequency. Percentile, GLM, F-test, T-test, Duncan's Multiple Range Test, Pearson's Correlations Analysis Simple Regression Analysis, and Multiple Regression Analysis. The results of this research are as follows; 1. The awareness of environmental management knowledge had significant differences according to the variables such as housewife's age, husband's job, family number, education experience of environment, frequencies of contracting mass media, the perceived adequacy of resources, social-altruistic orientation. 2. Among all of these variables affecting the awareness of environmental management knowledge, the perceived adequacy of resources had the highest effects and the next were family number, social-altruistic, type of residence in order. 3. Total Environmental management behavior of housewives had significant differences according to the variables such of environment, frequencies of contracting mass media, the satisfaction of household labor, the perceived adequacy of resources, biospheric orientation, social-altruistic orientation, egoism orientation, the awareness of environmental management knowledge. The clothing, eating, housing, family management behavior had the high level, the buying management behavior had the average level. The clothing, eating, housing, buying, family management behavior had significant differences according to the variables such as the satisfaction of household labor, the perceived adequacy of resources, biospheric orientation, social-altruistic orientation, egoism orientation, the awareness of environmental management knowledge. In particular, the clothing, eating, housing, buying management behavior had significant differences according to the variables such as education experience of environment. And the housing, buying management behavior had significant differences according to the variables such as frequencies of contracting mass media. 4. Among all of theses variables affecting environmental management behavior, the most influence variables was awareness of environmental management knowledge and the next were influence of housewife's job, biospheric orientation, the satisfaction of household labor, education experience of environment, frequencies of contraction mass media, egoism orientation in order. Among all of theses variables effecting the clothing, eating, housing, buying management behavior the variables affecting the family management behavior, the most influences variables was housewife's job. In the result of analysing the housewife's environmental management behavior and awareness of environmental management knowledge, influences of education experience of environment had the highest effect and frequencies of contracting mass media may more influencial than other variables. And Concrete and systematic knowledge and technique of environmental education is requisite. The result of this study could be attributed to develop the efficient environmental information. More emphasis should be given to environmental education and a long range environmental policy. in particular, environmental education be effectively related to environmental behavior, life-education and systematic support must be provided. In addition, further study of environmental problem is needed for and application of various theoretical approaches and research method.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.143-149
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• 2005

Purpose: The aim of this study was to evaluate the significance of pH monitoring at two levels, hypopharynx and esophagus in gastroesophageal reflux. Methods: 29 patients with pathological gastroesophageal reflux were classified into two groups: Group I had recurrent respiratory symptoms and Group II had not recurrent respiratory symptoms. The ambulatory pH monitoring was performed at the hypopharynx and the esophagus simultaneously with two channel catheter for 18~24 hr. The pathological reflux was defined when the percent of time that pH was below 4.0 exceeding the 95th percentile of normal value. Hypopharyngeal reflux was defined as the pharyngeal pH drops below 4. Results: 39 patients were performed pH monitoring at the level of hypopharynx and esophagus for 24 hours. Among 7 patients with chronic respiratory symptom, 6 patients (85.7%) have pathological esophageal reflux. Among 32 patients without chronic respiratory symptom, 23 patients (71.8%) have pathological esophageal reflux. Thus 29 out of 39 patients (74%) have pathological esophageal reflux. In the Group I, all parameters except the longest episode showed significant differences between hypopharyngeal and esophageal pH monitoring. None of parameters showed significant differences between group I and II in the pharyngeal pH monitoring. Conclusion: Regardless of presence of respiratory symptoms, the pH monitoring at the pharyngeal level in patients with gastroesophageal reflux did not showed any differences compared with the esophageal pH monitoring. Therefore we may reconsider the usefulness of hypopharyngeal pH monitoring in patients with chronic respiratory symptoms.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.9-16
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• 2000

Purpose: The aim of this study was to determine how much acid exposure would occur in the proximal esophagus, both in normal and in patients with abnormal distal esophageal acid exposure. Methods: Fourty-six patients with suspected GER were classified into two groups, 24 patients with pathological distal reflux (group I); 22 patients with normal distal reflux (group II). The ambulatory dual-probe esophageal pH monitoring was performed for 18-24hr. The abnormal reflux was defined when the percent of time that pH was below 4.0 exceeded the 95th percentile of normal value. Results: The siginficant differences between distal and proximal esophageal pH recordings in group I persisted for all parameters except for the longest episode, but didn't persist in group II. At the distal esophageal site, the median percent time with pH<4.0 in group I was 19.3 and significantly higher than at proximal site. Half of patients with pathological distal reflux also had proximal acid reflux. Correlation coefficients between the distal and proximal esophageal sites in group I of the number of reflux episodes and time of the longest episode were 0.451 and 0.646 respectively. Conclusion: The 50 percent of patients with pathological distal acid reflux also had abnormal acid exposure in the proximal esophageal site. Therefore, we recommand simultaneous pH recordings from dual probe esophageal sites in children with gastroesophageal reflux.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.116-121
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• 2008

Purpose: Cricopharyngeal incoordination is a rare cause of swallowing difficulties in newborns and infants; it is characterized by delayed pharyngeal contractions related to cricopharyngeal relaxation. Dysphagia and repeated aspiration are common findings despite normal sucking. We conducted this study to assess the clinical features of cricopharyngeal incoordination in newborns and infants. Methods: An analysis of the clinical data from 17 patients with cricopharyngeal incoordination who were admitted to the Department of Pediatrics, Pusan National University Hospital, between 2000 and 2006 was conducted retrospectively. The diagnosis of cricopharyngeal incoordination was established by the clinical characteristics and the videofluoroscopic swallowing studies. Results: The male to female ratio was 1:1.1 (males 8, females 9) the age range 1 to 60 days. The body weight of 11 patients (64.7%) was less than the $10^{th}$ percentile at diagnosis. Six patients (35.3%) were born prematurely. The associated anomalies or diseases were chromosomal anomaly (2 cases), congenital heart disease (3 cases), and laryngomalacia, hypoxic brain damage or neonatal seizures (1 case each). The chief complaints of patients were recurrent aspiration pneumonia (10 cases), feeding difficulty (9 cases), dyspnea (4 cases), and chocking (4 cases). The severity of aspiration on the videoesophagogram or esophagogram was mild in 12 cases. The correlation between the severity of aspiration and the duration of tube feeding after the diagnosis was significant (p<0.05). Conclusion: Cricopharyngeal incoordination should be considered in the differential diagnosis of newborns and infants, without known risk factors associated with swallowing dysfunction, when they present with unexplained respiratory problems. Although the prognosis of cricopharyngeal incoordination is good, early diagnosis and tube feeding are recommended to prevent the complications associated with this disorder.

• The Journal of Korean Academy of Sensory Integration
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• v.13 no.2
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• pp.63-73
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• 2015

Objective : To report the effects of a specific intervention, the Interactive Metronome$^{(R)}$ (IM), on timing, attention and motor function of a children with ADHD. Methods : The study is case reports about two boys with ADHD. One boy who is born 2008 is attending general elementary school as a first year student (case 1), and another boy who is born 2001 is attending general elementary school as a second year student (case 2). For each case subject, IM training was provided during 3 weeks, from January 2015 to Febrary 2015. Evaluations were performed pre- and post-intervention in order to exam timing, attention and motor skills. The measurements uses in this study are Long Form Assessment (LFA) for the timing, RehaCom screening module for the attention, and Bruininks-Oseretsky Test of Morot Proficiency, second version (BOT-2) for the motor function. Results : The timing function was improved in both cases since both showed reduced response time for all motor tasks of LFA. In terms of attention, case 1 showed improvement of visual attention division, neglect and response Inhibition, and case 2 showed improvement of sustained attention. Lastly, in the BOT-2, case 1 showed improved the percentile rank of short (from 42%ile to 96%ile), and case 2 also showed similar improvement (from 21%ile to 66%ile). Conclusion : This study provides positive evidence that the Interactive Metronome$^{(R)}$ training has positive power to facilitate several body functions such as timing, attention and motor control of children with ADHD, through two case studies.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.203-209
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• 2010

Purpose : Growth impairment is usually observed in children with congenital heart disease (CHD). Studies on the final height and weight of this population are insufficient. Our aim was to evaluate the final height of children with CHD and to identify the relationship between CHD and growth. Methods : We recorded the values of final height and weights of 105 CHD patients (age, <19 years) who visited Chonnam National University Hospital between November 2000 and March 2009, and we reviewed the medical records. Results : The mean values of weight and height of male CHD patients were significantly lower than those of the normal subjects. Patients with severe growth impairment (below the third percentile of normal) included 5 males (8.6%) and 4 females (8.5%) with height less than normal and 9 males (15.5%) and 8 females (17.0%) with weight less than normal. The mean growth of the patients in the cyanotic heart disease group was lower than that of normal subjects, but a statistically significant difference was noted in the weights of males. In a comparative study based on the type of CHD, a significant difference was noted in weights of males. Patients with patent ductus arteriosus and those with tetralogy of Fallot had the highest and lowest mean values of weight, respectively. Conclusion : Growth impairment was more evident in children with CHD than normal children. Patients should be treated during an optimal time frame. Thus, CHD patients should be treated if follow-up studies indicate growth impairment.

• Journal of the Korean Institute of Landscape Architecture
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• v.40 no.6
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• pp.148-160
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• 2012

The main purpose of this paper is to deliver a climate analysis and evaluation method based on GIS by using airborne LiDAR data and Biotop type map and to provide spatial information of climate analysis and evaluation based on Biotop type Map. At first stage, the area, slope, slope length, surface, wind corridor function and width, and obstacle factors were analyzed to obtain cold/fresh air production and wind corridor evaluation. In addition, climate evaluation was derived from those two results in the second stage. Airborne LiDAR data are useful in wind corridor analysis during the study. Correlation analysis results show that ColdAir_GRD grade was highly correlated with Surface_GRD (-0.967461139) and WindCorridor_ GRD was highly correlated with Function_GRD (-0.883883476) and Obstacle_GRD (-0.834057656). Climate Evaluation GRID was highly correlated with WindCorridor_GRD (0.927554516) than ColdAir_GRD (0.855051646). Visual validations of climate analysis and evaluation results were performed by using aerial ortho-photo image, which shows that the climate evaluation results were well related with in-situ condition. At the end, we applied climate analysis and evaluation by using Biotop map and airborne LiDAR data in Gwangmyung-Shiheung City, candidate for the Bogeumjari Housing District. The results show that the aerial percentile of the 1st Grade is 18.5%, 2nd Grade is 18.2%, 3rd Grade is 30.7%, 4th Grade is 25.2%, and 5th Grade is 7.4%. This study process provided both the spatial analysis and evaluation of climate information and statistics on behalf of each Biotop type.

• Clinical and Experimental Pediatrics
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• v.45 no.11
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• pp.1389-1396
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• 2002

Purpose : This study was done to analyze the changes in the clinical conditions and the diagnosis of hypertrophic pyloric stenosis. Methods : We report a retrospective clinical analysis of 39 patients with hypertrophic pyloric stenosis from Jan. 1992 to Aug. 2001. The age and sex distribution, family and birth history, clinical symptoms, the ultrasonographic and the operative sizes of pyloric canals were compared. Results : The body weight was below the 3 percentile at admission in eight cases(20.5%). "Olive like mass" in right upper quadrant was palpated during physical examination in 23 cases(59%) and gastric peristaltic wave observed in six cases(15%). The ultrasonographic measurements showed that the pyloric muscle thickness to be $4.95{\pm}0.99mm$($mean{\pm}SD$), pyloric diameter $14.42{\pm}2.64mm$, and pyloric length $20.17{\pm}3.92mm$. Fredet-Ramstedt pyloromyotomy was employed in all cases. The operative measurements of the pyloric muscle thickness was $5.11{\pm}1.01mm$, pyloric diameter $15.01{\pm}2.47mm$, and pyloric length $22.32{\pm}3.43mm$. Conclusion : There was no significant difference between the ultrasonographic and operative measurements. Currently, the hypertrophic pyloric stenosis patients showed lesser clinical hallmarks of the disease. The earlier diagnosis using imaging studies before development of significant metabolic abnormalities is becoming an important factor that change the future outcomes of hypertrophic pyloric stenosis.

• Journal of the Korean Geographical Society
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• v.43 no.5
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• pp.681-700
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• 2008

In this study, the spatial and temporal patterns of changes in means and extreme events of temperature and precipitation across the Republic of Korea over the last 35 years (1973-2007) are examined. Over the study period, meteorological winter (December-February) mean minimum (maximum) temperature has increased by $+0.54^{\circ}C$/decade ($+0.6^{\circ}C$/decade), while there have been no significant changes in meteorological summer (June-August) mean temperatures. According to analyses of upper or lower $10^{th}$ percentile-based extreme temperature indices, the annual frequency of cool nights (days) has decreased by -9.2 days/decade (-3.3 days/decade), while the annual frequency of warm nights (days) has increased by +4.9 days/decade (+6.8 days/decade). In contrast, the increase rates of summer warm nights (+8.0 days/$^{\circ}C$) and days (+6.6 days/$^{\circ}C$) relative to changes in summer means minimum and maximum temperatures means are greater than the decreasing rates of winter nights (-5.2 days/$^{\circ}C$) and days (-4.3 days/$^{\circ}C$) relative to changes in winter temperatures. These results demonstrate that seasonal and diurnal asymmetric changes in extreme temperature events have occurred. Moreover, annual total precipitation has increased by 85.5 mm/decade particularly in July and August, which led to the shift of a bimodal behavior of summer precipitation into a multi-modal structure. These changes have resulted from the intensification of heavy rainfall events above 40mm in recent decades, and spatially the statistically-significant increases in these heavy rainfall events are observed around the Taebaek mountain region.